高血压患者颈动脉内膜与动脉硬化指数等相关因子变化的临床观察

目的探讨高血压患者颈动脉内膜与动脉硬化指数、血压、血脂、血尿酸、血纤维蛋白原等相关因子的关系,了解高血压合并动脉硬化的原因,为临床判断高血压患者的动脉硬化情况提供依据。方法选取门诊及住院患者中高血压病1、2、3级患者150例,分为颈动脉内膜正常组、增厚组和斑块组三组,观察各组颈动脉内膜中层厚度,动脉硬化指数、血脂、血尿酸、血纤维蛋白原等情况,用统计学的方法进行分析。结果与颈动脉内膜正常组相比较,IMT增厚组和斑块组的动脉硬化指数均升高（P〈0.01）,差异有统计学意义;IMT增厚、斑块形成与高血压的病程、血胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、血尿酸（UA）、血纤维蛋白原（FIB）呈正相关（P〈0.05）。结论高血压患者随着动脉硬化指数的升高,血管内膜增厚及动脉硬化斑块形成,血中TC、LDL-C、UA、FIB越高,颈动脉内膜越厚且斑块检出率越高。这些因子可作为了解高血压患者动脉硬化程度的指标,作为指导治疗及判断预后的客观标准。

Clinical Observation of the Changes in the Indicators of the Carotid Intima and Arteriosclerosis for the Patients with Hypertension

Objective To explore the relationship of the carotid intima with the relevant factors such as atherogenic index,blood pressure,blood lipids,uric acid(UA)and fibrinogen(FIB)for the patients with hypertension and understand the causes of hypertension complicated with arteriosclerosis so as to provide the evidences for the clinical judgment of atherosclerosis for the patients with hypertension.Methods 150 outpatients or inpatients of 1,2 and 3-grade hypertension were selected and divided into three groups,named a normal carotid intima group,a thickening group and a plaque group.The carotid intima-media thickness(IMT),atherogenic index,blood lipid,UA,FIB and the others were observed in each group and analyzed in statistics.Results Compared with the normal carotid intima group,the atherogenic index was increased in either IMT thickening group or plague group(P<0.01),indicating statistical significant difference.The IMT thickening and plague formation presented the positive correlation with hypertension,blood cholesterol(TC),low density lipoprotein cholesterol(LDL-C),UA and FIB(P<0.05).Conclusion For the patients with hypertension,the vascular intima is thickening and the arterial plague is formed with the increase of atherogenic index.The higher the levels of TC,LDL-C,UA and FIB in blood are,the higher the relevance ratio of the carotid intima-media thickening and plague formation is.These factors can be the indicators to understand the severity of atherosclerosis and as the objective criteria of the treatment guide and prognosis judgment.